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Research Question: Validity

This study aims to determine if there is an association between Vitamin D levels and the risk of treatment failure and relapse in TB patients undergoing treatment. The study uses a cohort design and plans to enroll adult TB patients aged 18-60 years in Dar-es-Salaam, Tanzania who meet the inclusion criteria and not the exclusion criteria. The results could be applicable to patients in the Philippines given similarities in patient populations and both countries having high TB prevalence rates.

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Dale P. Polvorosa
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29 views

Research Question: Validity

This study aims to determine if there is an association between Vitamin D levels and the risk of treatment failure and relapse in TB patients undergoing treatment. The study uses a cohort design and plans to enroll adult TB patients aged 18-60 years in Dar-es-Salaam, Tanzania who meet the inclusion criteria and not the exclusion criteria. The results could be applicable to patients in the Philippines given similarities in patient populations and both countries having high TB prevalence rates.

Uploaded by

Dale P. Polvorosa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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RESEARCH QUESTION

Is there an association of Vitamin D level and the risk of treatment failure and relapse TB patients
undergoing treatment?

P Adult patients receiving TB treatment

I none
C Vitamin D levels
O Risk of TB relapse and treatment failure

M Cohort Study

VALIDITY

Criteria
Inclusion Criteria:
 Men and women, age 18 to 60 years inclusive
 At least two positive sputum smears for tuberculosis
 Intention to stay in Dar-es-Salaam for at least 2 years after the start of TB therapy
 Subjects who grant informed consent to participation

Exclusion Criteria:
 Karnofsky score < 40%
 Hemoglobin < 8.5 g/dl
 Having had treatment for TB exceeding 4 weeks in the last 5 years
 Pregnant women

APPLICABILITY

 The study is relevant and valid in our own patients, in the year 2013 from the national
nutrition survey revealed a high prevalence of vitamin D insufficiency in adults in the
Philippines that could be a factor in the treatment of TB patients here in the country as
mentioned in the journal that optimal vitamin D status may be associated with a more
effective immune response to TB infection and better long term outcomes. The results can be
applied to the local population given that the inclusion criteria in the study have similarities
with the patients seen in the department (eg. men and women, age 18 to 60 years
inclusive, at least two positive sputum smears for tuberculosis) . In the world health
organization’s TB profile in the year 2017 both Tanzania and the Philippines have high TB
prevalence as shown below:

TANZANIA

PHILIPPINES

Treatment failure by 1 month was defined as positive AFB cultures at 1 month from the initiation of treatment.
Relapses were deemed to have occurred in patients with positive cultures, among those who had become culture
negative after treatment initiation. Relapses/recurrences included both endogenous reactivation and exogenous
reinfection, which could not be distinguished in this study.

7-Dehydrocholesterol (an intermediate in the synthesis of cholesterol that accumulates in the skin) undergoes a
nonenzymic reaction on exposure to ultraviolet light, yielding previtaminD (Figure 44–3). This undergoes a further
reaction over a period of hours to form cholecalciferol, which is absorbed into the bloodstream. In temperate
climates, the plasma concentrationof vitamin D is highest at the end of summer and lowest
at the end of winter. Beyond latitudes about 40° north or south
there is very little ultraviolet radiation of the appropriate wavelength
in winter.

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